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Biomedical subjects

H F Mahieu

Publications and source records attributed to H F Mahieu.

47 records · Page 3Linked to original sources
PubMed1991

[Voice rehabilitation following larynx extirpation using the Groningen button].

The long term results of implantation of the 'Groningen button' after total laryngectomy were determined retrospectively in the ENT Department of the University Hospital Groningen, after follow-up periods of 6 months to 5 years. The study group consisted of 86 patients who received a Groningen button between 1981 and 1985, 79 men and 7 women with an average age of 60.5 years at the time of the total laryngectomy. The Groningen button is a silicon valve, which is introduced into a tracheo-oesophageal shunt, thus preventing aspiration of oesophageal contents and keeping the shunt open. The valve can be placed primarily during the laryngectomy or secondarily after the laryngectomy. The results of the voice restoration with the Groningen button were better than the results achieved with the injection oesophageal speech only. The results of a primarily constructed shunt with placement of the button were better than those of a button placed secondarily more than one year after the laryngectomy. The average lifetime of a button was about 3 months. The buttons of one-third of all patients were removed permanently after some time. In our study the complications were few. In our opinion a Groningen button can be placed during a laryngectomy to achieve a better voice restoration.

Esophagus↗
PubMed1991

Aerodynamic properties of the low-resistance Groningen button.

Shunt tracheoesophageal speech is currently the most successful form of voice and speech rehabilitation in laryngectomees. Insertion of valve prostheses into the tracheoesophageal shunts has overcome drawbacks caused by stenosis of the shunt and aspiration. In 10 years of satisfactory results with the standard Groningen button valve prosthesis, the overall concept of this device has proved its value. The airflow resistance, however, is relatively high, so that a low-resistance device has been developed without changing the favorable characteristics of the standard device. The design of this low-resistance Groningen button is described. The airflow resistances of the standard and low-resistance Groningen buttons have been measured and compared. The airflow resistance of the low-resistance Groningen button is also compared with the reported airflow resistances of various other valve prostheses.

Air Pressure↗
PubMed1989

New surgical techniques for voice improvement.

Laryngeal framework surgery for improving or changing the voice is a challenging development in phoniatric surgery. Basically two categories can be distinguished: (1) attempted medialization of the vocal fold, as for the treatment of paralytic dysphonias (arytenoid rotation technique and Isshiki's type I thyroplasty); (2) adjustment of the vocal fold's tension to produce changes in vocal pitch, as for the treatment of transsexuals or mutational dysphonia (cricothyroid approximation, Isshiki's type III thyroplasty and LeJeune's anterior commissure laryngoplasty). Both types of surgery are best performed with the patient under local anesthesia so that fine tuning of the voice is possible by monitoring the voice during the surgical procedure. The techniques of arytenoid rotation and Isshiki's type I thyroplasty are described in detail and the result of a combination of these procedures is illustrated by a case history of an aphonic patient with unilateral vagus nerve paralysis and subsequent severe incomplete glottal closure during phonation. In addition, the results achieved in several other patients are presented. Our current experience with laryngoplastic surgery and its variations is such that endolaryngeal Teflon or collagen injections are no longer used in our department. To date, we have seen no complications from the laryngoplasties and the voice results have been excellent.

Adult↗
PubMed1987

Pharyngoesophageal myotomy for vocal rehabilitation of laryngectomees.

Pharyngoesophageal myotomy, performed in 16 laryngectomees to improve vocal rehabilitation, proved to have some negative side effects. Although no failures of speech rehabilitation using a button were consequently found, a considerable number of button assisted esophageal speakers had a breathy voice. Also, the number of poor injection-esophageal speakers was much higher than in the group of nonmyotomized laryngectomees. A "normal" pseudoglottis could only rarely be identified by fluoroscopy in the myotomized group. A significantly lower intratracheal pressure appeared to be required for tracheo-esophageal phonation after myotomy. To improve the slightly disappointing voice rehabilitation results of the myotomized laryngectomees, a modified myotomy is proposed.

Esophagus↗
PubMed1986

Candida vegetations on silicone voice prostheses.

Deposits found on the esophageal surface of silicone voice prostheses (used in postlaryngectomy voice rehabilitation) are held responsible for malfunction of the valve mechanism. Cultures and scanning electron microscopic examinations proved these deposits to consist of Candida organisms growing not only on the surface of the prosthesis but also into the silicone material itself. It is remarkable that the patients are apparently not affected by these Candida organisms. Selective decontamination of the oropharynx and coating of the prosthesis with poly-methyl methacrylates, or impregnation with antimycotic agents or disinfectants, may prove effective methods in prolonging the life of the device.

Candida↗
PubMed1986

Oropharynx decontamination preventing Candida vegetation on voice prostheses.

Candida vegetations found in silicone voice prostheses used in postlaryngectomy voice rehabilitation are associated with prosthesis dysfunction. Selective oropharyngeal decontamination with amphotericin B lozenges resulted in sharp decrease of oropharyngeal Candida concentrations with a subsequent reduction of yeast colonization on voice prostheses and in tracheoesophageal fistula in ten patients. A case report suggests that this selective oropharyngeal decontamination can prolong the device's lifetime.

Administration, Oral↗
PubMed1984

Groningen prosthesis for voice rehabilitation after laryngectomy.

Singer and Blom's endoscopic technique, using a single valved silicone prosthesis, constituted a dramatic advance in speech rehabilitation following total laryngectomy. Since 1980, we have developed a silicone biflanged prosthesis that overcomes some of the inconveniences of previous prostheses. Insertion via the mouth and the oesophagus, or as a primary procedure during total laryngectomy is easily done with the use of specially developed instruments. The success rate in 36 patients in which the voice button was inserted at the time of total laryngectomy was 86.2%.

Adult↗
PubMed1981

Photoelectric plethysmography--some fundamental aspects of the reflection and transmission method.

In photoelectric plethysmography a distinction is made between the reflection methods. Uncertainties still exist, especially regarding the origin of the reflected signal: some investigators attach quantitative value to the amplitude of the plethysmogram. The various findings are reconsidered. Various fluids are pulsatingly pumped through an in vitro circuit. Flow, pressure and volume pulsations are measured, as is the total light intensity detected by a photoelectric plethysmograph with the small variations caused in it by the pulsations in flow. Both phase and amplitude of the resulting plethysmogram are studied and the results compared with those found in vivo at the fingers and auricles. In vitro, the variations in light reflection are in phase with the volume pulsations: this can only be ascribed to reflection by orienting erythrocytes. In vivo, however, the light reflection, like the light transmission, is in anti-phase with the volume excursions, thus eliminating the determinative effect of light reflection by orienting erythrocytes--the strong reflection from surrounding tissues completely dominates reflection from erythrocytes. Since erythrocytes also have absorptive properties, and the light reflection is in anti-phase with the volume excursions, it is concluded that this absorptivity can manifest itself over the strong reflection from surrounding tissue. In vivo, therefore, the reflection plethysmogram is, in principle, an absorption measurement. The relationship between intensity of detected light and resultant voltage may not be linear: this nonlinearity may not be neglected when amplitude changes are compared. Amplitude changes of different plethysmograms may only be compared quantitatively if there is no difference in their light-voltage relationship.

Blood Physiological Phenomena↗
PubMedDate not supplied

Sino-nasal bony and cartilaginous destruction associated with cocaine abuse, S. aureus and antineutrophil cytoplasmic antibodies.

Three male patients aged 29, 30 and 34 years and a 36-year-old female are reported with nasal septum perforation and a history of cocaine abuse. Two of the patients also had a perforation of the hard palate. In all four, antineutrophil cytoplasmic antibodies (ANCA) were found. One had a cytoplasmic immunofluorescence-staining pattern (c-ANCA), the other three showed a perinuclear staining pattern (p-ANCA). Furthermore, all patients were found to be nasal carriers of S. aureus. We hypothesise that tissue damage to the nasal and palatal area in patients using cocaine may partly be mediated by the presence of ANCA antibodies. Furthermore, we speculate that S. aureus facilitates the development of these ANCA antibodies.

Adult↗